Obesity in Singapore with Dr. Ganesh Ramalingam

Dr Ganesh Ramalingam

Like malnutrition, obesity is not a common issue in all parts of the world, including Singapore. It has been a health issue that keeps on increasing every year. Obesity is more than being overweight. Even though both terms are identified as a weight-related health problem or having too much body weight, obesity is still worse than being overweight. An overweight person’s Body Mass Index (BMI) is 25.0—29.9 while obese is 30 and over.

In Singapore, it is not new that a lot of locals are dealing with this health problem across all ages. It came to the extent that Singapore even conducted a program for students to have healthier options in school to prevent the early causes of obesity.

Credits: Healthhub

How common is it to be obese in Singapore?

Not only Singaporeans are dealing with health issues related to obesity, it has been a worldwide phenomenon where each of these countries are taking actions to prevent the rates from increasing. The common reason behind the cause of obesity is lack of physical movement and excessive food intake.

Compared to other countries, Singapore is not quite competing with the number of patients that are obese, including people who are overweight. However, the numbers are still high, considering that the count has not dropped for years.

Based on the World Health Organisation’s statistics, since the year 1980, the number of patients dealing with obesity has doubled as of 2019. This includes children, adults, and the elderly. According to the 2017 National Population Health Survey in Singapore, obesity among Singaporeans from 18 to 59 was 8.9%, while seniors 60 to 74 was 6.9%. While obese children are recorded 13% from ages 6 to 18.

The problem with obesity- aside from an unhealthy lifestyle- is the lack of awareness among people. Not knowing the importance of preventing the disease is causing the people in Singapore to underestimate the problem. If the locals continue to ignore the possibilities and chances of being obese, then the chances of increasing the disease may grow up to 15% in the next 7 years.

As people continue to become overweight, and eventually obese, the rate of people with diabetes might also increase and lead to other health complications such as heart disease or stroke, type 2 diabetes, and osteoarthritis, which are life-threatening diseases.

Dr Ganesh Ramalingam

Luckily, there are many experts that are actively addressing the issue of obesity, helping people become more aware of its repercussions and solutions. One of these is Dr. Ganesh Ramalingam. Dr. Ramalingam is a surgeon from G&L Surgical who specializes in gastrointestinal, bariatric advanced laparoscopy and endoscopic surgery. He was invited by Yahoo news to explain and give a broader knowledge about obesity and how you can aid it.

How Does Weight Loss Surgery Treat Obesity?

Losing weight might be difficult for those who have reached the point wherein working out and having a healthy diet alone is their least option to solve the problem because it no longer works for them. This is why there are people who are convinced of the idea of getting weight loss surgery instead. Weight loss surgery, according to Dr. Ramalingam, has been proven to produce long-lasting weight loss results.

To provide some background knowledge, these are the different kinds of weight loss surgery in Singapore that may be able to help you lose weight.

Sleeve Gastrectomy

Gastric Sleeve

Credits: G&L Surgical

Sleeve gastrectomy or also known as Vertical Sleeve Gastrectomy is a surgical weight loss procedure. It is a laparoscopic procedure that involves using compact instruments inserted in multiple small incisions in the upper abdomen. About 80% to 85% of the stomach is removed and binds the remaining parts of the stomach together, leaving it like the shape of a banana.

The purpose of giving a smaller stomach is to limit the amount of food that a person can consume. It also leads to hormonal changes that may also affect weight loss. The benefits of preventing high blood pressure and heart disease are also included when getting a sleeve gastrectomy.

Gastric Bypass Surgery

Gastric Bypass

Credits: New Life Bariatric

The procedure starts by dividing the stomach into two sections. The smaller upper section and the larger bottom section. The pouch or the upper section is the container of food that will enter the body, which is approximately the size of a walnut. The amount of food that the pouch can cater is about 1-ounce or 28 grams. This is followed by connecting the small intestine or the jejunum to a small hole into the pouch. It is done to help your body absorb fewer calories.

Laparoscopy

Credits: Healthline

This weight loss procedure is also called Keyhole Surgery or Minimally Invasive Surgery. It gives access to the surgeon inside the abdomen and pelvis without the necessity of creating a large incision.

It is possible to use a smaller incision because the surgeon uses a device called a laparoscope. It is a small tube that has a built-in light and camera where the surgeons can easily view the inside of the abdomen/pelvis through a monitor.

However, getting surgery is a big decision to make. You must understand and know the importance of the consequences of taking the surgery. Getting weight loss surgery doesn't mean you have the ticket to eat as much as you want. Taking the surgery has responsibilities too. It requires maintaining a healthy lifestyle such as diet and exercise. Former eating habits may not be suitable for your stomach anymore and may destroy the idea of having the surgery.

Can Young People Undergo Weight Loss Surgery?

As mentioned earlier, younger people are now also affected by obesity. An example of this is Nikhil Gangaram. Nikhil is a 19-year-old boy and one of the youngest patients of Dr. Ramalingam, who formerly weighed 122.8kg before undergoing Bariatric Surgery. Same as most people, Nikhil also went through an excessive diet and exercise, yet, had no result of losing weight.

After the surgery, Nikhil achieved losing 20.1kg in over a year by decreasing his food intake. He mentioned that bariatric surgery is the "most painful thing" he has gone through in his life. But, this "most painful thing" he did, became his most satisfying achievement. He even considers it as a "miracle".

It may not be usual for children or teenagers to undergo Bariatric Surgery, but most of the patients the surgeons have handled are young ones. Since Singapore obesity rates on youth have been increasing, it may help the youth prevent health issues in the future and better understand the importance of living a healthy lifestyle. Dr. Ganesh Ramalingam shared that lifestyle and diet change within the family is key for weight loss among young people.

Dr. Ramalingam also mentioned the surgery does produce results. According to him, 50% to 60% is the amount of weight a patient can lose after the surgery.

Are There Non-surgical Ways to Treat Obesity?

Non-surgical alternatives are also available when it comes to weight loss procedures.

  • Maintaining a controlled diet and exercise regime

    Before getting surgery, the first steps people try to help themselves reduce weight are diet and exercise. Everyone knows that maintaining a healthy lifestyle is the key to prevent future illnesses including obesity and other conditions related to obesity like heart conditions and diabetes. Nevertheless, some cannot manage to recover from being overweight and obese, which leads them to undergo check-ups and consultations for alternative solutions. 

  • Injectable medication (Saxenda)

Saxenda is considered one of the injectable drugs used for weight loss. It is similar to an insulin injection but made for people who need assistance in losing weight. Initially, Saxendra was used for treating diabetes until they discovered that it can also help with blood sugar levels and appetite centers in the brain that can help cure obesity. It is approved by the Health Science Authority in Singapore.

  • Gastric Balloon Procedures

The gastric balloon or endoscopic intragastric balloon is an innovative way to help people who have problems with losing weight ditch the option of getting weight loss surgery. It is safe and effective and doesn't require invasive surgery.

The balloon is a non-surgical weight-loss procedure. It involves inserting a specialized balloon in the stomach to occupy space for the person to minimize the food capacity of the stomach. This turns your usual eating capacity into a lesser intake of food.

The Allurion Elipse Gastric Balloon doesn’t require any sedation or endoscopy for removal and insertion of the gastric balloon. The form of the inflated balloon is similar to a pill that helps the patient swallow the balloon easily with a glass of water. It also comes with smart tracking tools for qualified nutritionists & doctors to monitor your weight loss progress.

Unlike weight loss surgeries where they usually have to staple your stomach to decrease its size, the balloon works by taking up space in your stomach and reducing the consumption of food to limit your appetite. As a result, it can help you lose about 10% to 15% of your total body weight in only 4 months. Also, with losing a significant amount of weight, the results of the balloon can help in having your body's cholesterol level and diabetic status toned down.

How to Prepare for Weight Loss Surgery?

  • Set a realistic expectation

    Sometimes people tend to expect too much. Eventually, this causes people to feel disappointed. Regardless of the process of losing weight, including diet, exercise, or surgery, every procedure doesn’t produce results as soon as you want to. Most of the time with weight loss surgery, patients see results after at least six months. Most effectively when patients follow post-surgery recommendations and advice from the doctor properly. 

  • Get support for long term weight loss 

Credits: Catholic Health

It will not be easy to convince yourself that you are done with your old eating habit. Once in a while, it will come to mind, especially when you don't have a good support system that will help you ignore temptations. This can be your family or friends, or you can also join a support group that supports weight loss online. This will mentally help you a lot especially when you are new to weight loss surgery. They can also help before you enter the idea of having surgery. They can help you understand more of the procedure and the responsibilities after the procedure.

  • Confront food addictions

Credits: Rinag Food

It is hard to admit that food has to turn into an addiction. It is something that people sometimes deny because food normally just makes them feel good. The problem is, there is always a limit on everything. After weight loss surgery, it is important that you become true to yourself about your eating habits before the surgery. This will help people around you and your doctor to guide you on how to manage your intake of food after having weight loss surgery.

  • Motivation rewards 

Credits: Talkspace

People love being rewarded after doing or achieving something. This is important if you are fighting to lose weight to motivate yourself and feel that you are doing something right. This will help you forget the frustration or the pressure of losing weight. This can either be a new dress, a summer getaway, or anything that is not related to food. Anything that you think will make you happy after reaching your goal. It is essential most of the time because people who are trying to lose weight somehow experience depression or anxiety. The idea of getting a reward after the hard work is giving these people a sense of fulfillment, making them enjoy what they're doing more than feeling pressured.

Losing weight is not easy. Mostly to those who did not grow up in an environment that practices healthy living. It takes a lot of self-motivation and motivation from your surroundings to achieve a healthy weight. That is why getting support from your friends and family, or other support groups are essential not only to be part of your weight loss journey but also mentally.

And before deciding to get weight loss surgery, make sure you understand the details completely and consult a doctor who specializes in gastrointestinal, bariatric advanced laparoscopy and endoscopic surgery to make sure you are getting help from the right person. Please seek advice from a qualified doctor to assess eligibility for this program.